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* To whom correspondence should be addressed. E-mail: ho.lee.mee{at}sgh.com.sg.
The objective of this retrospective study was to
distinguish between fertile and subfertile men based on
their semen parameters and hamster egg penetration test
(HEPT) outcome. This study involved 110 subfertile men
recruited from an infertility clinic and 48 fertile men
attending an antenatal clinic in Singapore. The men were
required to donate a semen specimen for semen analysis and
HEPT assay. The results indicated that the subfertile
group had significantly lower normal sperm morphology
according to the Tygerberg strict criteria, and lower
progressive motility (p <0.05). Semen volume, density,
HEPT decondensation rate, and sperm penetration index were
not significantly different between the two groups.
Receiver operating characteristic curve analysis indicated
that sperm morphology had the highest predictive power of
65.7%, with a threshold value of 7%; and progressive
motility had a predictive power of 61.8%, with a threshold
value of 50%. Using the tenth percentile of the fertile
population as the cut-off, lower thresholds of
3% for
sperm morphology and <28% for progressive motility were
obtained, giving higher positive predictive values of
81.8% and 84.4%, respectively. This study shows that these
new cut-off values can be used to screen the general
population to identify subfertile men. In contrast, the
HEPT proved to be an insensitive and unreliable assay in
identifying subfertile males. To our knowledge the
comparison of HEPT and semen parameters between subfertile
and fertile men has not been previously reported in an
Asian population.
Key words: Semen Analysis
Sperm
Normal Motile Count
Sperm Function Assay
Sperm Morphology
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